1487350633 NPI number — ELIZA GRIFFIN MSS, LCSW

Table of content: ELIZA GRIFFIN MSS, LCSW (NPI 1487350633)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487350633 NPI number — ELIZA GRIFFIN MSS, LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRIFFIN
Provider First Name:
ELIZA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSS, LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GRIFFIN
Provider Other First Name:
ELIZA
Provider Other Middle Name:
FRANKLIN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1487350633
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/26/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
140 W GERMANTOWN PIKE STE 160
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLYMOUTH MEETING
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19462-1421
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-892-3800
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
140 W GERMANTOWN PIKE STE 160
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLYMOUTH MEETING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19462-1421
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-892-3800
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/31/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  SW138622 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: CW025092 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)